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High Blood Pressure Causes

In 90 to 95 percent of high blood pressure cases, the cause is unknown. In fact, you can have high blood pressure for years without knowing it. That's why it's the “silent killer”  When the cause is unknown, you have what's called essential or primary hypertension. In the remaining 5% or less of people with elevated blood pressure, a specific cause is known, and they are considered to have "secondary hypertension." Examples of causes of secondary hypertension include kidney failure, narrowing of the arteries to the kidneys, and various hormonal conditions.
These problems can usually be corrected. For example, doctors can repair a narrowed artery that supplies blood to a kidney. Most of these problems can be ruled out by a careful history, a physical examination and a few tests. Special tests are sometimes needed, but you don't usually have to stay in the hospital.
Over 95% of people with elevated blood pressure have "essential hypertension." This means that the specific cause of their hypertension is not known. It is likely that both genetic (inherited) and environmental factors, such as your diet, play a role. The ways that all of the contributing factors interact to elevate blood pressure are not necessarily the same for each person. In addition, most of the genetic causes of hypertension are still a matter of research. Therefore, for the time being, most patients with high blood pressure are considered to have "essential hypertension."

In about 10% of people, high blood pressure is caused by another disease (this is called secondary hypertension). In such cases, when the root cause is treated, blood pressure usually returns to normal. These causes of secondary hypertension include the following conditions:

  • Chronic kidney disease
  • Tumors or other diseases of the adrenal gland
  • Coarctation of the aorta - A narrowing of the aorta that you are born with that can cause high blood pressure in your arms
  • Pregnancy
  • Use of birth control pills
  • Alcohol addiction
  • Thyroid dysfunction
In the other 90% of cases, the cause of high blood pressure is not known (referred to as primary hypertension). Although the specific cause is unknown, certain factors are recognized as contributing to high blood pressure.

Factors that can't be changed
  • Age: The older you get, the greater the likelihood that you will develop high blood pressure, especially systolic, as your arteries get stiffer. This is largely due to arteriosclerosis, or "hardening of the arteries." Hypertension, in particular the type that selectively increases systolic blood pressure (the "top" number), becomes steadily more common with advancing age. Older the patient, more will be the chances of hypertension
  • Race: African Americans have high blood pressure more often than whites. They develop high blood pressure at a younger age and develop more severe complications sooner.
  • Socioeconomic status: High blood pressure is also more common among the less educated and lower socioeconomic groups. Residents of the southeastern United States, both whites and blacks, are more likely to have high blood pressure than Americans from other regions.
  • Family history (heredity): The tendency to have high blood pressure appears to run in families.
  • Gender: For the vast majority of hypertensive patients, there is no one gene passed on (inherited) from parent to child that is responsible for high blood pressure. More likely, there are many different genes that interact with each other and the environment to produce high blood pressure. Therefore, inheritance predisposes a person to high blood pressure, but hypertension might only occur with the addition of one or more environmental factors. But it is possible that Hypertension may run in Families. So Family history is also significant of a hypertensive patient addition, African Americans are more prone as a group to develop hypertension and develop it at a younger age than those of other races or heritage.
    Generally men have a greater likelihood of developing high blood pressure than women. This likelihood varies according to age and among various ethnic groups.
Factors that can be changed


  • Overweight (obesity): Obesity is defined as having a body mass index (BMI) greater than 30 kg/m2. It is very closely related to high blood pressure. Medical professionals strongly recommend that all obese people with high blood pressure lose weight until they are within 15% of their healthy body weight. Your health care provider can help you calculate your BMI and healthy range of body weight.

    The reasons why obesity may lead to hypertension are not completely understood, but weight reduction in obese patients definitely lowers blood pressure. The benefits of even a modest reduction in weight are multiple: reduction or elimination of blood pressure medications, improvement in cholesterol levels, and decreased risk of heart attack. Unfortunately, as many patients can attest, weight reduction is easy to recommend but difficult to achieve and maintain. A daily exercise program, a strong social support system, and initially modest goals for weight loss are all required for long-term success.
  • Sodium (salt) sensitivity: Some people have high sensitivity to sodium (salt), and their blood pressure goes up if they use salt. Reducing sodium intake tends to lower their blood pressure. Americans consume 10-15 times more sodium than they need. Fast foods and processed foods contain particularly high amounts of sodium. Many over-the-counter medicines, such as painkillers, also contain large amounts of sodium. Read labels to find out how much sodium is contained in food items. Avoid those with high sodium levels.

    It has been known for a long time that societies with diets high in salt experience more hypertension and the associated complications of heart attack, stroke, and organ damage. It is not known, however, if increased salt is itself responsible for elevated blood pressure. It might be, for example, that people from societies with increased salt intake may also have some other dietary factors or an inherited factor that is responsible for their hypertension. Most physicians do not believe that high salt intake alone causes hypertension, but they do believe it plays an important role. The most likely explanation is that there are other environmental and genetic factors that along with high salt intake all work together to cause hypertension. More salt you take, your kidneys will retain more water inside body, resulting in increased blood pressure.
  • Alcohol use: Drinking more than one to two drinks of alcohol per day tends to raise blood pressure in those who are sensitive to alcohol.

    Although the media has widely publicized the beneficial effects of alcohol on the heart, it must be remembered that this applies only to moderate alcohol intake. People who have more than two drinks per day are much more likely to have sustained elevations in blood pressure than nondrinkers. Alcohol may therefore be an unrecognized cause of hypertension in a large number of moderate to heavy drinkers.
  • Birth control pills (oral contraceptive use): Some women who take birth control pills develop high blood pressure.
  • Lack of exercise (physical inactivity): A sedentary lifestyle contributes to the development of obesity and high blood pressure.
  • Drugs: Certain drugs, such as amphetamines (stimulants), diet pills, and some pills used for cold and allergy symptoms, tend to raise blood pressure.
  • Emotional Stress or Caffeine Cause High Blood Pressure: Emotional stress, in the short term, can elevate the blood pressure. However, it does not cause a persistent elevation in blood pressure and therefore does not cause true hypertension with its associated consequences. Relaxation therapies and biofeedback may offer other benefits, but they have not been shown to prevent the development of hypertension or significantly lower blood pressure.

    Similarly, caffeine may raise the blood pressure in the short term (and should not be ingested immediately before a doctor checks your blood pressure). However, tolerance to caffeine develops quickly, and any blood pressure elevation is not sustained.
As body weight increases, the blood pressure rises.
  • Obese people are two to six times more likely to develop high blood pressure than people whose weight is within a healthy range.
  • Not only the degree of obesity is important, but also the manner in which the body accumulates extra fat. Some people gain weight around their belly (central obesity or "apple-shaped" people), while others store fat around their hips and thighs ("pear-shaped" people). "Apple-shaped" people tend to have greater health risks than "pear-shaped" people.
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